Provider Demographics
NPI:1053633438
Name:GEMMA WALL LLC
Entity Type:Organization
Organization Name:GEMMA WALL LLC
Other - Org Name:HEARING SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEMMA
Authorized Official - Middle Name:SICAM
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:281-855-8916
Mailing Address - Street 1:16103 W LITTLE YORK RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-6868
Mailing Address - Country:US
Mailing Address - Phone:281-855-8916
Mailing Address - Fax:281-855-9193
Practice Address - Street 1:16103 W LITTLE YORK RD
Practice Address - Street 2:SUITE F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6868
Practice Address - Country:US
Practice Address - Phone:281-855-8916
Practice Address - Fax:281-855-9193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50426231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty